Delivering a hard-fought victory in President Obama’s yearlong pursuit of a national healthcare overhaul, a divided House narrowly approved legislation Sunday night that could reshape the way Americans deal with wellness and illness.

House Democratic leaders proved they could hold the majority caucus together, passing the Senate version of the healthcare legislation, 219-212, after weeks of arm-twisting and politicking.

A reconciliation package of amendments was also expected to pass the House on Sunday night. That measure, which will resolve disagreements between the House and Senate bills, will have to go to the Senate under a “budget reconciliation” process. It can be passed by a simple majority and cannot be filibustered.

29 Responses to “House Passes Health Care Reform 219-212”

You’ve gotta give Nancy Pelosi the credit she is due, and admire what she pulled off this night. In her comments, she was very complimentary to the President (of course), but the reality is that it was her heel marks up and down Emanuel Rahm’s back that gave Barack the backbone to go for it, and it was her leadership that corralled the majority.

“One for the history books.”? Mmm. Ok. This was an extraordinarily bad bill that is on its way to becoming an historically bad law, but that’s the future. Tonight, the Democrats really accomplished something. No question. No qualification. Nobody can take that away from them. And nobody did a better a job of articulating exactly what they accomplished then Dennis Kucinich:

“This bill represents a giveaway to the insurance industry… $70 billion a year, and no guarantees of any control over premiums, forcing people to buy private insurance.” – Dennis Kucinich

George W Bush – move over. Barack Obama has taken your place as the biggest corporate statist President of all time.

So now we’re into the next phase. I wonder how much more mileage the GOP can get from trying to sustain brinksmanship after the brink has passed.

As recently as last week someone here was saying that the “battle for public opinion had been lost.” What will polls show now, and going forward? Will stridence and hyperbole and dire warnings still play as heroism for Republicans? Or will it start to look like sore loserism?

IMO, people are ready for the next subject. It will be hard for conservatives to keep people focused on the healthcare reform law as democrats turn their eyes to stuff like wall street regulations and maybe even immigration.

Now it’s off to the courts to nibble the act to death, and the campaign trail, where the cry for the next two election cycles shall be “full repeal now.” Anyone who thinks that this is over is more deluded than poor Stupak, who will soon realize that he was bought for thirty pieces of pyrite. No matter how you slice it—even Alan Grayson admitted as much, although he had a very different road forward in mind—this is not the end. It is not even the beginning of the end. It is, at most, the end of the beginning.

And, by the way, will someone explain to me what the Senate’s motivation is to waste time on the reconciliation bill? The Senate and the House just squared off on competing versions of HCR legislation, and the Senate won. Why, given all the other business before it, would it now waste time on a bill that seeks to make HCR look more like the House bill that it rejected and prevailed over?

@simon
Easy. The bill legislation is generally acknowledged to be a giant piece of stinking crap by the right, left, Reps, Dems, liberals, conservatives, unions, management, small business, big business – pretty much everyone. So… it is important for our elected representatives to do a little turd polishing before the election season kicks into high gear.

Now it’s off to the courts to nibble the act to death, and the campaign trail, where the cry for the next two election cycles shall be “full repeal now.”

I think you overestimate the public’s taste for continuing to debate legislation after it has passed into law. And their attention span. Granted, this is all just happening as we speak, so it may take awhile for conservatives to get used to the fact that they’ve lost.

Stalwarts such as yourself are certain to have already talked themselves into undying opposition. So you are unlikely to accept the possibility that regular folks will start to see continued obsessive conservative whinebagging as sore loserism.Most people don’t want to keep talking about this after the reform has passed. They move on to waiting and seeing what will actually happen. And since the payouts don’t kick in until 2013, American minds are bound to move on to other subjects.

I know many conservatives are banking on public antipathy towards congress being directed primarily at democrats. I think it’s a more widespread anti-incumbent bias. Conservatives will surely pick up some seats. But I expect tone-deaf pols who rely primarily upon finger pointing across the aisle to find tough rowing, whether they are pointing leftward or rightward.

Americans want congresscritters to point fingers at themselves and stop blaming the other guys. Congressfolk need to have a Pogo moment where they admit “we have seen the enemy, and he is us.”

MW, that’s true, but it’s their piece of crap. If they pass the House changes, they necessarily admit that they voted for crap last year.

KK—paraphrased, “you have to get used to the fact that you’ve lost”? Said the south to the north after Fort Sumpter. You’re confusing the battle with the war; this has simply been the opening skirmish, and if Democrats were britons, this battle was more Bunker Hill than Waterloo. You don’t think there’s precedent for repealing a disastrous, divisive policy? I bet the supporters of prohibition felt pretty cocky on January 17th, 1919, also.

I’m somewhat lost in all of those analogies, but regardless, I could not disagree more. David Frum, a much better writer than I, sums it up:

“No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?”

“The legislation is generally acknowledged to be a giant piece of stinking crap by the right, left, Reps, Dems, liberals, conservatives, unions, management, small business, big business – pretty much everyone…

…..that I desire to listen to”

There are many people who don’t believe it’s a giant piece of stinking crap on the right, left, Reps, Dems, liberal, conservatives, unions, management, small business, big business….There are many people who support it and believe it’s been too long coming. There are those that vehemently disagree with your opinion, and they are not all liberals.

JMG, Frum is wrong. Justin has a separate thread discussing his article, here. The gist is pretty simple: Frum fails to recognize that the GOP could not have secured significant concessions from the Democrats that would have made this bill acceptable, and their refusal to deal now allows them to credibly campaign on full repeal in a way that they would have been unable to do had some Republicans defected. Of course, Frum is correct that Obama will not sign a repeal, and the GOP will not have a veto-proof majority in the Senate—but so what? Who said that this is an issue for the 2010 cycle only? This is an issue for at least the next two election cycles. You and KK (and Frum) need to get this through your heads: I understand that you guys think you’ve won, and you’re flush with success, but this is not over. The GOP is going to run on repeal. Senate Republicans have already said they will campaign on repeal in 2010; Mitt Romney has indicated that he will campaign on repeal in 2012; and as of Sunday, polls suggest that 59% of Americans oppose the bill. And if you want to cite opinion leaders, I see your David Frum and raise you a Bill Kristol; Kristol is at least as influential as Frum. We are going to run on repeal, we are going to win a bunch of seats in 2010, and this will be taken as evidence (rightly vel non) that the issue is a winner for 2012, which will make repeal a central theme in that election.

Mike, talk to MW, not me—it’s his quote, not mine, and to the extent that you’re correct, my point is strengthened not weakened. If MW is right, and the Senate bill is a pile of crap, the Senate has little incentive to admit that point by taking up the House amendments; if you’re right, and the Senate bill is peachy, it has even [i]less[/i] incentive to make it worse by taking up the House amendments.

@Mike
That was my quote, not Simon’s, and that is why I used the word “generally” as opposed to “universally”. Polls show that most people opposed this bill. Not Health Care Reform – this bill. I agree that a lot of people think Health Care Reform has been a long time coming. I am among them. I just don’t see that this bill reforms much of anything, and what little it does do, does not kick in for years, and does it at enormous cost.

I completely agree that liberals are not the only ones that support this mess. In fact, it appears to me that most principled liberals hate this bill. It is more partisan political Democrats that like it.

Your citation of Mitt Romney’s opposition platform is, in a word, hilarious. Here in my native Massachusetts, the healthcare plan that he helped pass as governor shares a lot of the features of President Obama’s plan: individual mandates, subsidies for people who can’t afford insurance, and expanded Medicaid benefits. If Romney does indeed run on a Repeal platform, I can sum it up in one word: hypocrisy.

I’m sure for many ideological conservatives, the Repeal platform sounds like a fantastic way to fire up the base. But, once people stop going bankrupt due to illness, job loss and subsequent health insurance loss; once small businesses start seeing savings through alliance bargaining; and once workers start seeing their employers passing those savings on to them in the form of real wage increases, that is where I disagree with the efficacy of a Repeal platform translating into electoral success.

JMG, you have entirely missed the significance of Romney’s declaration. Whether Romney is a good candidate or bad, and whether he would be a good President or bad, are irrelevant. What is relevant for present purposes is that he is a leading contender for the Republican nomination, and he has taken a position on an issue that has now vaulted to something approaching an instant litmus test status in the GOP. This puts enormous pressure on the other candidates to take a position, and relieves them of any anxiety about going first. And do you believe that any of those candidates will distinguish themselves by taking a contrary position? What is their incentive to do so? Whether you view this as a race to the top or to the bottom, it is almost certainly the upshot of Romney’s announcement. Look for Gingrich and Palin to follow suit within days if not hours.

I think that your second paragraph misses the mark, also. Anxiety about Obamacare’s effect on the economy starts today. The costs start to kick in soon. Yet even those who are skeptical of repeal concede that the benefits—such as they are—don’t kick in until after the next Presidential election. For reasons best known to themselves, the Democrats have frontloaded this reform’s liabilities. Thus, even if you were correct about the bill’s benefits (and I suggest that you both exaggerate the benefits and completely ignore the costs), repeal could be a done deal before they would materialize. Your argument is essentially that this bill has the latest and greatest in parachute technology—but that will not save it, I suggest, it if it’s released one minute above the ground and the chute is designed to open two minutes after release.

I don’t often agree with David Brooks, but I suspect that his comment on the News Hour friday may well prove prophetic:

I think the loser — in the short term, the winner loses. If it passes, people will say, hey, they proposed this reform. My insurance rates are still going up. Costs are still going up. What happened? If the Republicans defeat it, they will say, hey, my insurance rates are still going up. Those guys defeated a reform effort, because I think one thing we can be sure of, certainly over the next several years, nothing much will happen for a lot of people.

There will be some changes, but, for most people, their premiums will still be going up. The costs will still be going up. And they will blame whoever they think is responsible.

I think that’s a pretty realistic analysis. I think the GOP was already on course to make significant gains in the fall, because it has reunited and independents have become more skeptical of the Democrats. The ugly endgame of Nancy’s Folly has only amplified both tendencies, it has exacerbated public disgust with Washington, which always redounds to the benefit of the opposition party to one extent or another. All this may spell a GOP Congress come next year that has every incentive to put Obama on record vetoing repeal, and 2012 candidates who have every incentive to say they’ll sign repeal, all of which will reduce Obama to having to plead that “if we just hang in there, the benefits will kick in soon.”

I think this strategy is a winner. But win or lose, that’s the road forward. Mark Shields owes David a dinner.

It is completely relevant that Mitt Romney, the leading GOP candidate, made a heath care policy for Massachusetts as its governor, which much of the national plan emulates. Mr. Romney, clearly an influence on the national GOP field, (or at least Mr. Gingrich and Mrs. Palin) said in 2006:

So how can he, with a straight face, campaign against the nation plan that does just that? It is unfortunate that the politics of the GOP has become so craven.

Next, your citation, which is not exactly an unbiased source, essentially argues against your thesis. Moreover, the statement that “Most of the imagined benefits of Obamacare would not kick in until 2014,” is demonstrably false.

This year, the new law will set up a high-risk health insurance pool for those currently uninsured. It also ends the practice of screening for pre-existing conditions effective immediately. People (and most importantly children) with pre-existing conditions (like myself) are now able to purchase health insurance. Finally, and most importantly, lifetime and yearly coverage caps will end, this year. That means that people who have already purchased insurance, and who become gravely ill, will no longer go bankrupt because that had to audacity to need care that exceeded the caps imposed by their insurer.

In fact, if history is any indicator at all, running on a platform of Repeal anytime past 2010 midterms should yield as a fantastic failure. Proposals that have increased a guarantee of health insurance in America have always been controversial, yet always become popular once they go into effect.

Now, I would like to make a personal note. Without going into to much detail, I have a congenital issue that has lead to a catastrophic failure of one of my senses. Any place outside of Massachusetts (and, I believe, Hawaii) I am unable to purchase insurance. Simply due to a twist of my genetic fate, my potential residence is limited to 2 of our 50 states, so long as I would like to have my health remain insured. Starting this year, because of this bill, specifically the law that ends pre-existing conditions screening, I can now purchase insurance anywhere in the country.

So don’t tell me this bill doesn’t have any immediate benefits. Any candidate who runs on a platform of Repeal will be inundated with countless stories from people like myself. Such a platform is both bad politics and bad policy.

As to costs, am I more than happy to discuss them in depth, specifically with respect to our 20-year budget outlook on health care spending, on a later post.

JMG,
i) I revise my previous remark: you have completely ignored or misunderstood the significance of Romney’s declaration. That you dislike Romney is not relevant to the likely behavior of other GOP Presidential contenders. As I explained above, Romney’s endorsement of a repeal platform puts pressure on other Presidential frontrunners to do likewise. I understand that you think Romney is a hypocrite, but your opinion of Romney is not a factor that leading Republican Presidential candidates carefully weigh. They do, however, take notice of what other leading Presidential candidates say on high-profile issues. Your own comment concedes the point: Romney, you admit, is “clearly an influence on the national GOP field.” That is precisely the point, that why his declaration is significant, and that is why your objections miss the mark.

But, but, you complain, “how can he, with a straight face, campaign against the nation plan that does just that?” Who knows? Who cares? That is not relevant to what other GOP Presidential candidates will do. What is relevant, is that one of their leading rivals has taken a position that will be very popular with the primary voters for whose affections they are competing.

ii) You observe that the Reason “essentially argues against your thesis.” It doesn’t essentially do so, it squarely does so. I acknowledged as much (“even those who are skeptical of repeal concede …”), and I would have thought it obvious that their opposition to repeal does nothing to undercut the point for which it was cited. It is unexceptional to cite something for its data while disagreeing with its conclusions; indeed, to the extent the data can be construed as an admission against interest, it validates the data.

iii) I question how much the bill does this year, even assuming that a district judge does not grant a preliminary injunction (a high but not insurmountable bar under Winter v. NRDC) in at least one of the dozens of challenges to Obamacare that are about to be filed before the ink is dry on the President’s signature. Nevertheless, I will stipulate to it for sake of argument, because it only marginally undercuts the force of the point. The lion’s share of the harms of Obamacare kick in before the next Presidential election while many of its benefits will not flower until afterward. That is all that is relevant here. Hostile voters are unlikely to be swayed by promises of “soon,” leaving Obama with whatever small core of fans is left by 2012. I expect him to lose by approximately the margin he won by in 2008.

Yes, that Kristol reference stopped me dead in my tracks….if Kristol is “an authority” anything following immediate clouds up and is unreadable to me…too bad, I suspect Simon had a point in there somewhere.

Well, the Kristol reference makes a lot of sense in light of my going back and reading the *I don’t often agree with David Brooks* comment. Yes, why would anyone agree with one of the more moderate, thoughtful conservative pundits around? I don’t always agree with him either, but he’s intellectually honest, unafraid to change his opinion when confronted with new evidence, and is as far from the irrational opposition party hatred that poisons our current discourse as one can get. Discounting Brooks and lauding Kristol is about as self-revelatory as one can get…

[…] pounded in the coffin this week when on Sunday, over bipartisan opposition, the Democrats in the House of Representatives passed HR 3962 – the Affordable Health Care for America Act, and it was signed into law by the […]

[…] nonsense. Dennis Kucinich is a man of principle. He would never sell his vote in such a cheap and tawdry manner. Far more likely, he sold his vote for a promise of a job in the […]

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